- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …to help us transform healthcare? Bring your true colors to blue. The Senior Manager of Medicare Strategy and Business Planning will report to the ... Vice-President of Medicare Strategy and oversee critical business reporting...opportunities for improvement or variance from expected outcomes. The senior manager will create multiple presentations on… more
- Point32Health (Canton, MA)
- …often intended for senior leadership and/or strategy teams. The Sr Pharmacy Program Manager supports the Pharmacy department in conducting industry ... and effective presentations. The Sr Pharmacy Program Manager also collaborates with select Point32Health Strategy ...implement strategic projects. The Sr Pharmacy Program Manager functions as a senior project … more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …your true colors to blue. The Medicare Risk Adjustment Strategy Program Manager will report to the Senior Director of Medicare Risk Adjustment and ... ensure complete and accurate medical record documentation and coding. The Program Manager will contribute to the development of strategies and facilitate discussion… more
- CVS Health (Wellesley, MA)
- …of work supporting multiple lines of Aetna business, including Commercial, Group Medicare , and Medicaid. Your success will hinge on your ability to collaborate ... Recommend, research and develop facts, quotes, and scenarios to support creative strategy and execution. + Ensure messaging, brand guidelines and directives are… more
- Amazon (Boston, MA)
- …This role will spearhead business development solutions for Amazon Pharmacy payer strategy , driving key growth and profitability goals of the business. Within the ... PBM, health insurance, pharmacy, business development, marketing, managed care, Medicaid, Medicare Part D, and commercial innovation. - Bachelor's degree in… more
- Point32Health (Canton, MA)
- …service to our members, partners, colleagues and communities. **Job Summary** The Senior Clinical Pharmacist is responsible for the development and maintenance of ... and accreditation requirements and to meet Point32Health's corporate priorities. The Senior Clinical Pharmacist also oversees the structure and activities of the… more
- CenterWell (Providence, RI)
- …part of our caring community and help us put health first** The Senior Strategy Advancement Professional provides data-based strategic direction to identify and ... for business segments or the company at large. The Senior Strategy Advancement Professional work assignments involve...will be responsible for supporting the CenterWell ACO and Medicare payment model programs via the Center for … more
- WellSense (Boston, MA)
- Senior Provider Relations Consultant, BH Network Strategy WellSense Health Plan is a nonprofit health insurance company serving members across Massachusetts and ... New Hampshire through Medicare , Individual and Family, and Medicaid plans. Founded 25...development of training materials** + **Works collaboratively with the Manager of Behavioral Health Network Strategy to… more
- Datavant (Providence, RI)
- …educational and life experiences to realize our bold vision for healthcare. As a Sr . Client Coding Project Manager , you will plan, forecast, and manage ... work environment. + Keep up to date with current coding policies for ICD-10, Medicare Advantage, HHS (ACA), and other markets. + Provide guidance and make strategic… more
- Elevance Health (Smithfield, RI)
- …Medicaid Services to transform federal health programs._ The **Audit and Reimbursement Senior ** will support our Medicare Administrative Contract (MAC) with the ... of the Department of Health and Human Services). The Audit and Reimbursement Senior will support contractual workload involving complex Medicare cost reports and… more
- Elevance Health (Boston, MA)
- ** Strategy & Program Development Director - Payment Integrity Strategy & Planning** **Location:** This role requires associates to be in-office 3 days per week, ... be considered. Travels to worksite and other locations as necessary. The ** Strategy & Program Development Director** is responsible for coordinating the relationship… more
- Prime Therapeutics (Providence, RI)
- …Quality Manager Stars and Quality - Remote **Job Description** The Senior Client Quality Manager ensures the successful planning, implementation and ... established client quality goals + Drive the client quality strategy for all lines of business ( Medicare ,...quality strategy for all lines of business ( Medicare , Medicaid, Commercial/HIM); serve as primary point of contact… more
- Humana (Providence, RI)
- …industry in how digital can be used to drive customer acquisition in the Medicare Advantage space. We are aggressively driving new digital capabilities, new ways of ... working, and employing next-gen technology to revolutionize how Medicare Advantage is sold. This role is part of...be critical in our growth plans. The Principal Product Manager Leads all phases of the product life cycle,… more
- Point32Health (Canton, MA)
- …the Director, Customer Experience (CX), the CX Measurement & Improvement Program Manager is directly responsible for leading two heavily regulated annual survey ... programs and strategic improvement initiatives. The Customer Experience Program Manager is key role on the enterprise Customer Experience team and is responsible for… more
- Highmark Health (Providence, RI)
- …growing number of laws and regulations governing managed care organizations. The Manager , Medicaid Compliance & Operations acts as a trusted business partner, ... Audit Committee. + Prepare regular reports on operational compliance performance for senior management, highlighting key trends and areas for improvement. + Other… more
- CVS Health (Woonsocket, RI)
- …the opportunity to lead our client acquisition and retention strategy for our Medicare specific products. The Senior Manager will work within the ... with heart, each and every day. **Position Summary:** The Senior Manager of Client Management - Care...be focused on the successful management of our growing Medicare product business. You will be focused on identifying… more
- CenterWell (Providence, RI)
- …Kentucky, Tennessee, Louisiana, and more. The PCO has a strong emphasis on senior -focused primary care for members of Medicare Advantage health plans and ... The IPA CMO will develop and support the MSO's National Clinical Vision and Strategy , directly lead a team of regional & area medical directors and serve as… more
- Humana (Providence, RI)
- …industry in how digital can be used to drive customer acquisition in the Medicare Advantage space. Within this business area, we are aggressively driving new digital ... of working, and employing next-gen technology to revolutionize how Medicare Advantage is sold. This role is part of...We are seeking a highly skilled Lead Digital Program Manager to oversee the development and execution of a… more